The point made in the article "Focus on preventive care to improve heart health: Report" (June 28) is a call in the right direction.

Although it looks at steps to prevent unnecessary "relapses" in heart patients, the call should go beyond this scope.

Preventive measures to improve heart health and reduce cardiovascular incidents must start from childhood.

A disturbing trend we are seeing today is the increased number of heart attacks affecting those in their 40s and even some in their late 30s. Years back, we hardly saw heart attacks in this age group.

Parents must not allow their children to indulge at a young age in drinks with high sugar content, fast food, red meat and food rich in saturated fats and trans fat.

We are familiar with the dangers of obesity, but even in those who are not obese, such a diet started early contributes to high triglyceride levels in the blood, which in turn increase the risk of developing diabetes and cardiovascular problems.

High triglyceride levels and obesity lead to the development of non-alcoholic fatty liver disease (NAFLD) - the liver in a sense is infiltrated by fat.

A fatty liver increases the risk of cirrhosis, and even liver failure and liver cancer. This in turn leads to an increase in cardiovascular complications.

What is significant is that NAFLD can be corrected just by leading a healthy lifestyle and having proper nutrition, weight and exercise, without taking medication.

Many believe that alcohol intake itself is the cause of many liver problems, but let us not forget that diet and unhealthy lifestyles can cause liver problems too.

It is encouraging to hear Deputy Prime Minister Heng Swee Keat speaking of the need for work-life balance.

I have written about burnout in the context of work leading to insomnia, depression, gastric ulcers and anxiety.

It is noteworthy to realise that there have been cases of heart attacks not caused by blocked coronary arteries, but precipitated by severe stress, acute anger or despair, leading to spasms of the arteries, resulting in heart attacks. Some have termed them heart attacks arising from being "heartbroken".

In that light, a healthy work-life balance is a way to improve heart health. When there is no time to rest, which in turn means no time for exercise, and when there is an excessively unhealthy pressure to meet deadlines, these do not augur well for heart health.

Management as well as workers are responsible for ensuring a healthy work-life balance, otherwise all the improvement in technology and know-how in medicine cannot prevent a spike in a health crisis affecting more and more of our younger population.

Quek Koh Choon (Dr)